Provider Demographics
NPI:1194370189
Name:DAVIS, BARBARA LYNN
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:LYNN
Last Name:DAVIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:388 EDGEWATER AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:TN
Mailing Address - Zip Code:37321-7233
Mailing Address - Country:US
Mailing Address - Phone:423-775-4933
Mailing Address - Fax:
Practice Address - Street 1:388 EDGEWATER AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:TN
Practice Address - Zip Code:37321-7233
Practice Address - Country:US
Practice Address - Phone:423-775-4933
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-06
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker